The percentage of people with employment-based health insurance dropped from 70 percent in 1987 to 61 percent in 2004. This is the lowest level of employment-based insurance coverage in more than a decade.
The
Point of Service Plan (POS)
The Point of Service Plan (POS) gives
individuals the freedom to choose between an HMO or
a PPO option at the time service is rendered. The POS
plan requires individuals to have a primary care physician
(PCP) but gives individuals a choice of whether or not
to seek services within the network. Services rendered
outside the HMO or PPO networks are subject to payment
guidelines already in place for individuals who choose
to go outside the network providers, but most of the
costs involved in non-networked physicians are covered
partially.
The most beneficial route for using your
POS to its fullest is to use your PCP for regular checkups,
preventive care and tests, and referrals to specialists
instead of automatically taking things into your own
hands. When individuals decide to use an out-of-network
provider, the individual must pay the entire cost of
any care until the out-of-network rules reimburse the
individual for costs agreed to, often a higher co-payment
or coinsurance charges or deductibles. Individuals benefit
when they take the traditional route of following the
PCPs recommendations and referrals to specialists.
Another benefit of POS plans is that they
tend to offer more preventive services and programs
to inspire better health. Many offer workshops on how
to quit smoking or discounted health club/spa memberships.
This is a plan that encourages individuals to live healthier
lifestyles and has helpful options, such as workshops,
for those determined to better their lives.
This plan seems to fit any individual
or family that likes the freedom to move outside the
network when they see it necessary. Families might find
it comforting to know that if they do not agree with
the PCP, they have the option to get a second opinion
or see a specialist with some coverage available. Single
adults might see this appealing as well. If a problem
arises and they want to go on to the specialist, they
may do so knowing they will be responsible for the majority
of the costs. Either way, the POS plan gives individuals
a choice in deciding what to do when medical situations
arise, unlike standard HMOs.
Family-Health-Insurance reviews insurance services to provide information on products and options, but is not an insurer or a licensed agency. Coverage and policies described on this site may not be available in all states.
